Published on
April 3, 2024

Ask An Audiologist: Do You Recommend Real Ear Measurement for Fitting Hearing Aids?

Real ear measurement (REM) is critical for customizing hearing aids to the user’s specific auditory profile.
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We often receive questions about best practices when it comes to ensuring hearing aids meet individual hearing needs. Among the various steps in the hearing aid fitting process, one verification tool consistently comes up as a topic of interest – real ear measurement (REM). This process is critical for customizing hearing aids to the user’s specific auditory profile.

Real ear measurements involve a microphone and a thin tube being placed in the ear canal alongside the hearing aid. As we perform this measurement, we can precisely determine how sound is amplified by the hearing aid within the ear canal. This data informs us whether the hearing aid is providing the correct levels of amplification at different frequencies, tailored to the wearer's hearing loss.

Encouraging REM during hearing aid fittings is something we support because it directly impacts the effectiveness of the hearing aid. Without real ear measurements, there's a substantial risk that the hearing aids will not perform as well as they could. This could result in anything from inadequate amplification to discomfort or even further hearing damage. For us, ensuring our clients' hearing aids are set accurately is at the heart of our commitment to optimal hearing health.

Importance of Real Ear Measurement

Real Ear Measurement is critical for ensuring that hearing aids are programmed to meet the specific needs of each user's hearing loss. By using accurate sound pressure level measurements within the ear canal, we can provide an individualized fitting experience.

Accuracy in Hearing Aid Fitting

Real Ear Measurement allows us to verify that the hearing aid is producing the correct levels of amplification for all frequencies according to the user's audiogram. This process ensures:

  • Consistency: The REM process makes certain that hearing aids perform optimally, consistently producing the intended levels of sound.
  • Specificity: It tailors the device to the unique ear acoustics of the individual, considering the size and shape of the ear canal.

Personalized Hearing Aid Programming

Using REM, we can program hearing aids to match an individual's hearing loss profile precisely. This meticulous programming leads to:

  • Enhanced Speech Clarity: By adjusting the hearing aid based on precise measurements, users often experience significant improvements in speech understanding in both quiet and noisy environments.
  • Optimal Comfort: Personalized settings prevent over-amplification, which can lead to discomfort and further hearing challenges.

Real Ear Measurement Process

Real Ear Measurement (REM) is a crucial technique for ensuring hearing aids are accurately calibrated to an individual's specific hearing needs. It involves measuring and adjusting the sound output of the device within the user's ear canal.

Preparation and Setup

The patient will be seated in a quiet environment. The audiologist will place a thin silicone probe tube near the eardrum, ensuring precision without causing discomfort. This is done with utmost care to prevent any damage to the ear canal or eardrum.

Next, the hearing aid is inserted into the ear, with the probe tube positioned alongside it. The audiologist then connects the probe to the measurement equipment to ready the system for testing.

Testing and Adjustment

With the setup complete, the audiologist introduces a series of sounds through a loudspeaker. The probe microphone captures the sound levels near the eardrum to determine how the hearing aid amplifies sounds in the ear.

The audiologist reviews this data to identify discrepancies between the actual output and the target amplification levels. If necessary, the audiologist will make adjustments to the hearing aid settings directly. This ensures that both soft and loud sounds are amplified to the appropriate levels for the patient's hearing loss.

Verification and Fine-Tuning

Once adjustments are complete, we perform a verification step. The same types of sounds are played again, and the resulting data is compared to the desired output.

During fine-tuning, we may ask the patient for feedback on the sound quality and speech clarity. We refine the hearing aid settings further until the measurements align closely with the audiogram of the patient. This step ensures a personalized fit, providing the best possible hearing experience.

Challenges and Considerations

Variability in Ear Anatomy

Each individual's ear canal has unique geometrical and physiological characteristics, influencing how sound travels and resonates within it. This variability means that hearing aid settings customized for one person's ear canal may not be suitable for another. It can be challenging to anticipate these variances without precise measurement, which underscores the value of REM as it accounts for these individual differences.

Device Limitations and Compatibility

Not all hearing aids are capable of being optimized through REM, as some may lack the necessary features or programming flexibility. Additionally, the compatibility between the hearing aid and the measurement equipment is crucial. If the hearing aid is not compatible with our REM equipment, this can limit our ability to verify the fitting accurately. It is important for us to stay informed about the latest technological advancements to address such limitations.

Recommendations and Best Practices

In the fitting of hearing aids, real-ear measurement is a cornerstone of ensuring personalized, effective hearing solutions. We are proud to provide this precise verification process. When selecting hearing aids, the value of seeing an audiologist for real-ear measurement cannot be overstated. This service tailors the device to the unique acoustics of your ear, resulting in a more accurate hearing aid adjustment. Audiologists can leverage REM to enhance speech intelligibility and overall satisfaction with the hearing aid experience.

Opting for a hearing aid fitting without REM can lead to suboptimal results. To ensure that your hearing aid fitting includes a real-ear measurement carried out by an audiologist, contact us today.

Written by
Reviewed by
Dr. Julie Link
Founder & Audiologist
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Dr. Link was inspired to create The Audiology METHOD by the comments and suggestions made to her over the years by the patients she serves. While she loves working with patients of all ages, Dr. Link realized early in her career that busy working adults were a severely underserved population.